Individual provider · Type 1 NPI
Mutiat Ajibade, NURSE PRACTITIONER
Psychiatric/Mental Health Nurse Practitioner · Phialdelphia, PA
NPI number
1407480155
Active
Practice location
1401 S. 31 Street
Phialdelphia, PA 19146
Mailing address
131 Magpie Ln
Coatesville, PA 19320-4355
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | SP021594 (PA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
About NPI 1407480155
Mutiat Ajibade, NURSE PRACTITIONER's National Provider Identifier is 1407480155, issued on Mar 2, 2020. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Phialdelphia, PA. The record was last updated on Sep 11, 2023.